HPP Management Group, Corp.
5201 Blue Lagoon Drive
Suite 815
Miami, Florida 33126
Phone: (305)227-2383 or 1-877-938-9311
Healthcare
organizations may feel like there’s little time left to get ready for
the new code set during the final few weeks of the ICD-10 preparation
period. Providers should take advantage
of whatever time is left by making sure they have completed a series of basic
tasks.
Ø
Understanding
ICD-10 ( Mapping of ICD-9 to ICD-10 )
Ø
Meeting
Compliance Deadlines
Ø
Prepare ICD-10 for HEDIS /
PQRS
Ø
Flag Common Codes
Ø
Understand Clinical
Documentation
Ø
Creation of NEW Templates
Varying Changes by Clinical Areas Changes in the number of codes
Clinical Area
|
ICD-9 Codes
|
ICD-10 Codes
|
Fractures
|
747
|
17099
|
Poisoning and toxic effects
|
244
|
4662
|
Pregnancy related conditions
|
1104
|
2155
|
Brain Injury
|
292
|
574
|
Diabetes
|
69
|
239
|
Migraine
|
40
|
44
|
Bleeding disorders
|
26
|
29
|
Mood related disorders
|
78
|
71
|
Hypertensive Disease
|
33
|
14
|
End stage renal disease
|
11
|
5
|
Chronic respiratory failure
|
7
|
4
|
Sample of Mapping ICD-9 to
ICD-10
Common Codes
: FAMILY PRACTICE
ICD-10 Compliance Date: October 1, 2015
Abdominal Pain
(ICD-9-CM 789.00 to 789.09 range)
R10.0 Acute abdomen
R10.10 Upper abdominal pain, unspecified
R10.11 Right upper quadrant pain
R10.12 Left upper quadrant pain
R10.13 Epigastric pain
R10.2 Pelvic and perineal pain
R10.30 Lower abdominal pain
R10.31 Right lower quadrant pain
R10.32 Left lower quadrant pain
R10.33 Periumbilical pain
R10.84 Generalized abdominal pain
R10.9* Unspecified abdominal pain
Acute Respiratory
Infections (ICD-9-CM 462, 465.9, 466.0)
[Note: Organisms should be
specified where possible]
J02.8 Acute pharyngitis due to other specified organisms
J02.9* Acute pharyngitis, unspecified
J06.9* Acute upper respiratory infection, unspecified
J20.0 Acute bronchitis due to Mycoplasma pneumoniae
J20.1 Acute bronchitis due to Hemophilus influenzae
J20.2 Acute bronchitis due to streptococcus
J20.3 Acute bronchitis due to coxsackievirus
J20.4 Acute bronchitis due to parainfluenza virus
J20.5 Acute bronchitis due to respiratory syncytial virus
J20.6 Acute bronchitis due to rhinovirus
J20.7 Acute bronchitis due to echovirus
J20.8 Acute bronchitis due to other specified organisms
J20.9* Acute bronchitis, unspecified
Common Codes :
PEDIATRICS
ICD-10
Compliance Date: October 1, 2015
Ø Abdominal Pain
Ø Acute Bronchitis
Ø Acute Pharyngitis
Ø Allergic Inflammation of the Nasal Airways
Ø Asthma
Ø Chest Pain
Ø Diabetes Mellitus (Select)
Ø Headache
Ø Otitis Media
Ø Pain in Limb
Ø Routine Child Health Examination
Ø Urinary Tract Infection, Cystitis
Asthma (ICD-9-CM 493.00, 493.01, 493.02,
493.10, 493.11, 493.12, 493.20, 493.21, 493.22, 493.81, 493.82 , 493.90,
493.91, 493.92)
ICD-10
J45.20 Mild intermittent asthma, uncomplicated
J45.21 Mild intermittent asthma with (acute) exacerbation
J45.22 Mild intermittent asthma with status asthmaticus
J45.30 Mild persistent asthma, uncomplicated
J45.31 Mild persistent asthma with (acute) exacerbation
J45.32 Mild persistent asthma with status asthmaticus
J45.40 Moderate persistent asthma, uncomplicated
J45.41 Moderate persistent asthma with (acute)
exacerbation
J45.42 Moderate persistent asthma with status asthmaticus
J45.50 Severe persistent asthma, uncomplicated
J45.51 Severe persistent asthma with (acute) exacerbation
J45.52 Severe persistent asthma with status asthmaticus
J45.901* Unspecified asthma with (acute) exacerbation
J45.902* Unspecified asthma with status asthmaticus
J45.909* Unspecified asthma, uncomplicated
J45.990 Exercise induced bronchospasm
J45.991 Cough variant asthma
J45.998 Other asthma
*Codes with a greater degree of specificity should be considered
first.
Documentation Requirements
Concept
|
Number of Codes
|
Initial Encounter
|
13,932
|
Subsequent Encounter
|
21,389
|
Sequela
|
11,974
|
Right
|
12,704
|
Left
|
12,393
|
Routine Healing
|
2,913
|
Delayed Healing
|
2,913
|
Nonunion
|
2,895
|
Malunion
|
2,595
|
Assault
|
1096
|
Self-harm
|
1057
|
Accidental
|
1262
|
Anatomical location
Which
anatomical structure
·
Proximal,
distal, medial, lateral, central, peripheral, superior, inferior, anterior, posterior…
Laterality
Right side or left side
Severity
Mild, moderate or severe
Environmental factors
·
Smoking
·
Geographic location
For example: Otitis
Media
ICD-10 Relevant
Documentation Otitis Media Concepts:
Type:
•Serous
•Suppurative or non-suppurative
•Tubotympanic
•Atticoantral
•Allergic
•Mucoid
Type (alternate terms):
•Sanguinous
•Seromucinous
•Exudative
•Transudative
•Secretory
•with effusion (non-purulent)
•Catarrhal
•Purulent
•Myringitis
Associated with:
•With spontaneous rupture of the TM
•Without spontaneous rupture of the TM
•Infectious or other external agent…
•Smoking
o Exposure to environmental tobacco smoke
o History of tobacco use
o Occupational exposure to environmental
tobacco smoke
o Tobacco dependence
o
Tobacco
use
•Allergic or
non-allergic
Temporal Factors:
•Acute or subacute or chronic
•Recurrent
Laterality:
•Left or right
•Bilateral or
unilateral
The Diagnosis:
ICD-10
|
Description
|
B053
|
Measles complicated by otitis media
|
H6501
|
Acute serous otitis media, right ear
|
H65113
|
Acute and subacute allergic otitis media
|
|
(mucoid) (sanguinous) (serous), bilateral
|
H65194
|
Other acute nonsuppurative otitis media,
|
|
recurrent, right ear
|
H6532
|
Chronic mucoid otitis media, left ear
|
H66012
|
Acute suppurative otitis media with
|
|
spontaneous rupture of ear drum, left ear
|
H6613
|
Chronic tubotympanic suppurative otitis
|
|
media, bilateral
|
H6622
|
Chronic atticoantral suppurative otitis media, left ear
|
J1183
|
Influenza due to unidentified influenza virus with
|
|
otitis media
|
Poor quality
documentation is bad for Payers, Providers and Patients:
·
Billing
accuracy
·
Quality
measures
·
Population
management
·
Risk
management
·
Healthcare
analytics
·
Patient Care
The time to act is now!!!
FOR MORE INFORMATION
HPP Management Group, Corp.
5201 Blue Lagoon, Suite 800
Miami, FL 33126
Phone: (305) 227-2383
